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Table 2 Comparison of some advantages and limitations of skin prick test and molecular-based allergy diagnostics for allergy confirmation (adapted from 3,5)

From: Debates in Allergy Medicine: Allergy skin testing cannot be replaced by molecular diagnosis in the near future

Skin tests (extract based) Molecular-based sIgE tests (component based)
Available only where equipment, reagents and trained staff are on hand. Available only in laboratories with high-end machinery where specific reactives and trained staff are on hand.
Moderately costly. High cost.
Minor discomfort for scratching, itch if positive. Minor pain. Venesection may be painful or anxiety-provoking (particularly in children),
Requires patient cooperation. Performance in small children may be limited. Little patient effort or cooperation required.
Slight risk of systemic allergic reaction (more so in some special situations). A convincing recent history of anaphylaxis represents a contra-indication. No risk to patient; may be first line with certain high-risk allergens.
Require areas of normal skin for testing. Can be done regardless of extensive skin disease.
Must stop antihistamines and some other drugs several days before test. Can be done regardless of taken medications.
Methodology and result quality variable, standardization not always possible. No formal quality control at the current time. Laboratory test subject to strict quality control, reagent availability and technique standardization.
Results in 30 min Results may take days/weeks.
Results are visible and compelling to patients; may have value in ensuring compliance with allergen avoidance measures. Results are not directly meaningful to patients.
Can extemporaneously prepare allergens (with appropriate considerations; specialist practice). Some food allergens, drugs and pollens not available for testing.
In most cases have better sensitivity for clinically relevant allergies. Reasonably good sensitivity.
Fresh food allergens (prick-to-prick) available with good sensitivity. Fresh allergens not available.
No interference from high total IgE. False positives possible with high total IgE levels.
Numerical measurements may vary by different operators. Numerical results obtained on different types of equipment are not directly comparable.